Definition
Abscesses are collections of pus that can occur in different parts of the body. The abscess has its own capsule and creates its own body cavity by melting down tissue. This is called a non-preformed body cavity.
There can also be abscesses in the intestine due to various previous illnesses and causes. In the broadest sense, anal abscesses, the acute form of anal fistula, also belong to intestinal abscesses. Abscesses in the intestine are inflammatory events that can burst open (perforate) after a certain time. This allows the contents of the abscess to empty into the abdominal cavity.
Causes
An abscess in the intestine can arise from various causes or previous illnesses. Inflammatory processes in the intestine promote the development of abscesses. An initial inflammation can then develop into an abscess.
Diseases with a high inflammatory activity therefore tend to develop abscesses. Furthermore, abscesses can also develop more easily in diseases in which the immune system is weakened. So it is not surprising that a possible complication of diverticulitis is the intestinal abscess.
Diverticulitis is an inflammation of so-called intestinal diverticula. These are protrusions in the intestinal wall, which are found in over 50% of people over 70 years of age in the industrialised countries. They are caused by various factors and can become inflamed in the course of life.
Stool can accumulate in the diverticula and lead to a circulatory disorder in the intestinal wall. An inflammation is the result. The inflammation spreads and abscesses develop, which can empty into the abdomen when the diverticula burst through.
Another disease that can be the cause of an intestinal abscess is Crohn’s disease. This is a chronic inflammatory bowel disease whose cause is unknown. The high inflammatory activity in Crohn’s disease often leads to the development of fistulas and abscesses in the intestine.
Furthermore, a so-called perityphlitic abscess can develop in the context of appendicitis. This abscess develops as a complication of an appendix rupture and must be operated on immediately. Abscesses in the intestine can rarely also be caused by the introduction of foreign bodies into the intestine.
This can happen either by swallowing the foreign body or by an anal insertion of an object. The foreign body represents an inflammatory stimulus and can thus lead to the development of an abscess. Chronic diseases, such as diabetes, HIV or other diseases that suppress the immune system, make it easier for infections and inflammations to spread in the intestine. Although intestinal abscesses are rare, they can develop more easily in such a pre-existing condition.
Diagnosis
Bowel abscesses usually occur in the context of other previous diseases, such as Crohn’s disease or diverticulitis. They are considered a complication of the disease and occur when an inflammation spreads. Symptoms such as fever, a general feeling of illness, or abdominal pain may indicate an abscess in the intestine.
In most cases, regular check-ups by the family doctor or gastroenterologist are carried out in the case of pre-existing illnesses, in which intestinal abscesses are preferred. In the case of newly occurring gastrointestinal complaints, a specific search is then carried out for possible inflammations or abscesses. A quick and uncomplicated examination that can reveal an abscess is the abdominal ultrasound.
Fistulas and abscesses can be visible there. To determine the exact location of the abscess, other imaging procedures such as CT or MRI examinations are possible. Blood tests may reveal increased inflammation values such as CRP, blood sedimentation rate or leukocytes. However, these are unspecific values that do not have to be elevated in a closed abscess. Ultimately, the diagnosis of an abscess is made by imaging techniques.
